Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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January 4, 2016
Pilocytic Astrocytoma of the Spinal Cord
- Background:
- Cord pilocytic astrocytomas are a rare tumor in adulthood.
- Key Diagnostic Features:
- The signal is typically hyperintense on T2WI and iso-to-hypointense on T1WI, but can be heterogeneous due to admixture of solid and cystic components. The pattern of enhancement is variable, often intense in the solid portion (~80%).
- Nonenhancing intramedullary astrocytomas are not uncommon and comprise between 20% and 30% of intramedullary astrocytomas, but nonenhancing pilocytic astrocytomas are rare.
- Differential Diagnosis:
- Other astrocytomas
- Ependymoma
- Spinal cord glioblastoma multiforme
- In this case, as the tumor was a nonenhancing lesion, preoperative diagnosis was not possible.
- Treatment:
- Surgery is the treatment of choice (complete surgical resection in adults > 80%). Radiotherapy is to be used only with definite clinical and radiological progression.
